Patient Service Management Coordinator Suffern Office

The Services Management Coordinator plays a crucial role in the delivery of healthcare services for patients in the Selikoff Centers for Occupational Health as well as within the WTC Health Program Clinical Center of Excellence at Mount Sinai (Rockland County). The incumbent Services Management Coordinator serve as liaisons for patient care activities in the program and ensures coordination of care around the course of the patient visit as well as subsequent patient interactions between visits. The Services Management Coordinator is responsible for multiple components of the World Trade Center centered on care coordination within the programs. Specifically, Services Management Coordinator s are responsible for providing administrative assistance to our providers, nurses, medical directors, medical review and case management team. While working in collaboration with our various teams within our department the Services Management Coordinator takes a lead role in patient navigation, education and coordination of all aspects of the program, while connecting patients to other resources as needed and at the direction of the treating provider and/or nurse. The position also assists the patient with navigation of complex medical and pharmacy coverage as well as communication of coverage information to program patients, external providers and other team members within the program. As part of this complex navigation, the Services Management Coordinator will need to troubleshoot program challenges and use problem solving skills to make recommendation on future workflow. This position requires strong problem solving skills, analytical skills, strong organizational abilities, excellent communication skills and the ability to multitask. The position requires coordination of workflow across multiple specialties providers and program leadership and therefore requires effective communication. The Services Management Coordinator reports to the administrative managers within the Selikoff Centers for Occupational Health.

*Responsibilities for Internal Candidates

• Plays a lead role in the navigation of care and ensures that patients understand their overall program benefits as well as what they can expect the program to provide. This may include but is not limited to:Serves as a liaison with Physicians, patients and clinical staff to connect patients with relevant internal/external resources

Educates patients in conjunction with direct care from their providers related to medications, and continuing care requirements
Works cohesively with the Provider to facilitate the care plan by participating in daily huddles and monthly case discussions; coordinating information and care requirements
Identifies and develops workable solutions to resolve issues and/or concerns
Collaborates with other clinical staff, identify and resolve issues that could impact smooth care progression, and connects patients with relevant internal resources
Analyzes and ensures their providers schedule are at full capacity
Provides guidance to patients on signing up for various program resources while explaining the benefits in contacting their provider for any clinical questions/needs, requesting refills, getting access to their after visit summary and electronically checking in to appointments. This may include systems such as MyChart as well as other relevant electronic portals and systems available to the patient to facilitate care delivery.
In addition to an assigned register nurse, the coordinator is also the point person responsible in generating and submitting the WTCHP authorizations as long as its applicable to the patients care plan
Assisting the patient and family with resources and internal options in getting services covered under the patients care plan covered

• Sets goals with patient and care team to coordinator care, and documents goal in program dashboard and calendar tool. Follow ups to be tracked include: visit status reminders, scheduled follow up and specialty appointments, authorization submitted for review, coordination of specialty appointments, requesting medical records, resolving billing issues and other items as needed.
• Ensures that all orders placed by the providers (internal and external) are authorized after confirming the service falls under the patients covered services. This includes at minimum the following:Managing received request for specialty departments in need of authorizations

Preparing workers compensation documents such as C4-authorization and MG2 to submit to the workers compensation and tracking approval/denials.
Keeping the provider and workers compensation coordinators aware of any documents received to ensure additional required documents are submitted.
Maintaining information and sending reminders high acuity cases
Services as the primary point of contact to education patients pharmacy benefits, and assist with obtaining prior authorizations when applicable. This may include:

• Submitting refill request from patients or the patients preferred pharmaciesReviewing of the patient’s medication list and approved conditions for providers

Verifying the status of various coverage plans an options including review of coverage details within the relevant health plan
Preparing information for providers to assist with coverage and authorization decisions
Confirming preferred pharmacy location
Coordinating coverage between patient, provider, pharmacy and program sponsor

• Organizes patient correspondence and future program plans for the patient based on program interactions in the electronic medical record as well as in the program benefits systems. This involves ensuring that the a plan is made with next steps with respect to administrative coordination of the patient’s care, Timely documentation and follow up on action items required. This includes the timely generation and transmission of authorization for care to specialty providers
• Offers extensive patient navigation between program visits and other encounters. This includes detailed discussion with the patient to review next steps and resources, facilitation of patient concerns review, questions or concerns related to coverage, ongoing education to both patient and provider regarding coverage, and coordination with health plan analysts, case managers and providers to facilitate coverage and excellent patient care throughout all aspects of the program
• Educates and communicates closely with the patients to ensure they have a full understanding of the benefits offered by the program. Patient education provided on all relevant program benefits such as the World Trade Center certification process, the WTC Victims Compensation Fund, Worker’s Compensation and Social Work benefits
• Provides recommendations for process improvement and services improvement aimed at improving patient experience, and participates in ongoing pilot programs to improve patient engagement.
• Additional duties as assigned

*Qualifications for Internal Candidates

• 3 years’ experience in healthcare/customer service or relevant experience.
• H.S Diploma or equivalency; Bachelor's degree preferred

Job Type: Full-time

Pay: $58,824.00 - $65,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift

Ability to Commute:

• Suffern, NY 10901 (Required)

Work Location: In person